Cultivating Awareness of Others through Mindfulness

In the previous post, I mentioned the triad of awareness – awareness of self, awareness of others and awareness of the world around us.  In this post, I want to focus on awareness of others.

It is very difficult to be aware of others and thoughtful towards them in the busyness of our daily lives and the incessant distractions posed by disruptive marketing.  Our attention is continuously pulled away from inner awareness and awareness of others.

Our lack of awareness of others is often displayed in our blind spots – we are impervious to the effects of our words and actions on others.  It takes a conscious effort to get in touch with our core blind spot which may be blinding us to the needs of others in particular situations – whether at work, at home, or in the community.

Awareness of others requires that we move away from self-absorption.  We can become so immersed in our own feelings – pain, anxiety, sadness, boredom – that we are not aware of the feelings and pain of others.  We can also be so lost in our thoughts – planning, analysing, critiquing – that there is no room for thoughts of others.

Mindfulness to cultivate awareness of others

Mindfulness meditation is a way to break out of the trap of self-absorption – what Jon Kabat-Zinn describes as thinking that we are the centre of the world.  With conscious and consistent meditation practice, we can increase our awareness of, and empathy towards, others around us.

Loving kindness meditation, for example, enables us to think about others and express the desire for them to experience wellness and happiness.  It takes us outside our self to thoughts about others and their needs and desires.

A simple related exercise is to recall a situation that has occurred that has caused pain and suffering for someone else or a group of people and place yourself in their situation – “What would they be feeling if they have just lost their child through an accident?”   As you engage in empathetic consideration of the people involved – family, friends, colleagues – you can extend the desire for them to manage their grief and to eventually experience equanimity.  If you were to do this daily, this could help to cultivate awareness of others.

Forgiveness meditation is a way to take ourselves beyond focus on our own pain and hurt from an interaction with someone else, to thinking about and feeling for the other person in the interaction.  It takes considerable awareness to move beyond our own sense of pain and righteousness to reflect on what happened for the other person.  Forgiveness meditation is a powerful way to move beyond self-absorption to awareness of others.

As we grow in mindfulness through meditation and reflection, we can cultivate awareness of others – awareness of their pain, thoughts and needs.  We can move beyond being self-absorbed to being thoughtful of, and considerate towards, others.

 

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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Acceptance and Commitment Therapy (ACT): A Specialised Mindfulness Approach

In this blog I have been discussing different approaches to mindfulness and mindfulness meditation that are self-initiated and self-directed in the main.  Some of the approaches to mindfulness discussed entailed the involvement of a teacher or mentor to guide the participant through various forms of meditation.

One such approach is provided by the Power of Awareness Mindfulness Training conducted online by Jack Kornfield and Tara Brach.  Even in this course, led by teachers and mentors, there is ample scope for participants to pick and choose what types of meditations and mindfulness practices they will focus on – the choices are not individually focused or directed.

What is different about Acceptance and Commitment Therapy (ACT)

ACT as the name suggests is an approach that provides therapists with a structured approach to mindfulness development for their clients.  This approach is therapist-led with a defined sequence of exercises designed to enable clients to move from the entrapment of destructive thinking to taking effective action guided by their values (committed action).  Colleagues vouch for the fact that ACT often achieves the desired results in therapeutic situations.

ACT aims to enable clients to experience a full, rich and meaningful life that is built on internal and external awareness.  The approach actively discourages ineffective avoidance strategies and encourages acceptance of pain as a natural part of a life that is lived fully.    Just as mindfulness trainers are exhorted to deepen their mindfulness practice, so too ACT therapists are encouraged to practise the ACT approach and exercises to be able to act more consciously and effectively in therapy sessions.

The ACT approach to mindfulness

Mindfulness in the context of ACT is defined by Russ Harris, author of ACT Made Simple, in terms of the quality of paying attention:

Mindfulness means paying attention with flexibility, openness and curiosity.

In this definition, mindfulness is explained in terms of three key elements – awareness through paying attention, an open attitude and flexible attention enabling a narrow or wider focus or a focus on the internal or the external.

ACT incorporates six core processes as part of its therapeutic approach:

  1. Being here now – consciously focusing on the here-and-now, including our inner and outer worlds.  Fundamentally, it is about being present in the moment, rather than lost in thought.
  2. Watch what you are thinking – this involves standing back from your thoughts and observing them in a detached way. It means not entertaining them and being caught up in them as if they are reality.  Mindfulness expert, Kabat-Zinn suggests that we view our thoughts as bubbles in boiling water floating to the surface and bursting.  He provides the liberating idea that “we are not our thoughts” nor should we be captured by the “narratives” in our head.   In ACT, the process of observing our thinking is called “cognitive diffusion”.
  3. Accepting and being open to painfulness – Russ Harris describes this process as “making room for painful feelings, sensations, urges, and emotions”.  ACT provides exercises to develop this acceptance.  In our mindfulness discussions, we have offered mindfulness practices such as forgiveness meditation to address this pain and suffering.
  4. Observing yourself – ACT encourages awareness through getting in touch with the “observing self” rather than the “thinking self”.   Russ Harris describes the former as “the aspect of us that is aware of whatever we’re thinking, feeling, sensing or doing in any moment”.  Mindfulness practitioners encourage meditation practices like somatic meditation to develop this awareness.
  5. Knowing what matters – getting in touch with the way we want to be in the world (our values).  Values guide behaviour, give meaning to our lives and facilitate decision making.  Consciousness about our values can enable us to lead our lives with energy and vitality and provide mindful leadership for others.
  6. Doing what it takes – this involves doing what it takes, despite pain and discomfort, to live out our values in daily life (described as “committed action” in ACT).  It requires congruence between our words and actions and a readiness to commit to “valued living”.

ACT is a therapeutic approach that aims to help clients grow in mindfulness in order to lead a life that is richer and more meaningful, while reducing the impact of harmful thoughts and narratives and pain-avoidance.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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Self-Forgiveness

We have all hurt ourselves and other people during our lives – it’s part of being human.  Unfortunately, we can carry around the associated guilt, negative self-evaluation, and sense of unworthiness that act as a dead weight holding us back and weighing us down.

Self-forgiveness and self-compassion are essential for our mental health and wellbeing and for the development of wisdom.  Sometimes, the accumulated guilt for the hurts we have caused seems too great for us to tackle it.  The sense of guilt and shame becomes buried deeply in our psyche as we avoid confronting the hurt we have created by our words, actions or omissions.  Self-forgiveness is the way forward and the means to release ourselves from the tyranny of guilt.

However, we can often be held back by the misconceptions and unfounded beliefs we hold about forgiveness meditation Jack Kornfield identifies three myths that get in the road of our practising self-forgiveness:

  • Myth 1: Forgiveness is a sign of weakness – in reality, forgiveness requires considerable courage to “confront our demons” and deal with the pain of self-discovery.  The demand for courage is especially pertinent when addiction is involved.
  • Myth 2: Forgiveness means we are condoning the hurtful action – in fact, we often resolve never to do that hurtful action again or to avoid the situation where we are tempted to react inappropriately.  If we fail to address the guilt and shame, we are held captive and are more likely to take that hurtful action again
  • Myth 3: Forgiveness is a quick fix – it can be far from this.  Jack Kornfield recalled a mindfulness teacher that requested that he do a 5-minute forgiveness exercise 300 times over a number of months.  If we undertake forgiveness meditation, we can procrastinate or fall into the trap of the opposite of forgiveness (blame, self-loathing).  Sometimes self-forgiveness will involve a lot of pain, regression, diversion and ongoing effort to avoid falling back into a lack of loving kindness.

Self-forgiveness is something we have to keep working at as we go deeper into our feelings of shame and guilt and their hidden sources.  Jack Kornfield suggests that self-forgiveness releases us from the burden of the past and allows us to open to our heartfelt sense of our own goodness.

As we grow in mindfulness through self-forgiveness meditation, we can gain a sense of freedom to be ourselves, a newfound self-respect and energy for kindness and compassion towards others.  We will become less self-absorbed and weighed down and feel free to open up to others.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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Facing the Fear Within

We have explored the R.A.I.N. meditation process in a preliminary manner.  Now we will look at how R.A.I.N. can help us deal with those deep-seated fears that take control of us, reduce our capacity to live life fully and prevent us from showing others loving kindness.

The disabling effects of fear and anxiety

Jaak Panksepp, author of Affective Neuroscience, discovered that young rats who had played and frolicked together became totally inhibited when a piece of cat’s hair was introduced into their cage – creating an immediate fear response and disabling anxiety.  Jaak believed that in-depth insight into the behaviour of animals helped us to better understand human emotions.

Anna Steinhenge explored whether fear and the associated anxiety induced a similar inhibiting effect in humans.  She found that in competitive situations where people viewed the outcome with positive anticipation, they were readily able to access clear thinking and creativity; in contrast, where people were anxious about the outcome, their creativity and critical faculties were impeded, and they tended to engage in cheating or unethical behaviour to win.  One only has to look at the behaviour of the leadership group in the Australian Cricket team during the third test in South Africa to confirm this perspective – they were anxious that they could not win the third test, when the score was tied at one test each, so they engaged in ball tampering.

Using the R.A.I.N. meditation process to face and conquer the fear within
Recognise the fear

The first step is to recognise the fear for what it is – to face it fully, understand how it impacts our body and impedes our mind.  Avoiding facing the fear only makes it stronger and weakens our capacity to manage the fear and its disabling effects.

Kayakers, for example, have shown that when caught up in a whirlpool that is sucking them deeper into the water, they need to relax and go with the direction of the sucking force, rather than fighting the whirlpool which only saps their strength.  They need to go to the bottom of the whirlpool to survive.  So too with fear, we need to access the depths of the fear itself before we can be freed from its inhibiting effects.

Accepting the existence of fear

We need to accept that the fear is part of our life but learn how to gradually disassociate from it so that we are not identified with it.  Tara Brach tells the story of a woman suffering from PTSD who, while sitting on a park bench, envisaged her fear beside her while she continued to explore her connectedness to nature – to the birds, flowers and trees surrounding her.

Investigating our fear

Tara suggests that we explore the nature of our fear and even question what it is like, where it lies within us, how deep and dense it is.  She suggests that we explore our relationship with fear and determine what fear is expecting of us and how we want to relate to our fear.  We could question where fear resides in our body and how it manifests itself through pain and physical disturbance – headaches, muscle soreness, cramps, twitching or shaking.

Nurturing ourselves through fear

Trying to discount fear by purely rational processes will not remove the fear but only make it go underground, away from our consciousness.  We need to see the fear for what it is in all its manifestations but treat ourselves with kindness.  This may mean pulling away temporarily from facing our fear and its intensity to rebuild our resources and strengthen our resolve.  This is a gentle way to treat ourselves if we become overwhelmed when facing the depth of our fear.  After rebuilding our resources, we can resume the P.A.I.N. meditation process by again grounding our body and mind through mindful breathing.

Plumbing the depths

Tara Brach suggests that the P.A.I.N. meditation process can be employed to handle any deeply-felt, negative emotion such as grief, anguish or self-disgust, as well as fear.  In the course on the Power of Awareness, Tara discussed Leaning into Fear and highlighted the process of facing fear by quoting David Whyte’s poem, The Well of Grief, which also uses the analogy of “plumbing the depths”:

Those who will not slip beneath
the still surface on the well of grief,

turning down through its black water
to the place we cannot breathe,

will never know the source from which we drink,
the secret water, cold and clear,

nor find in the darkness glimmering,

     the small round coins,
thrown by those who wished for something else.

As we grow in mindfulness through the P.A.I.N. meditation process, we develop the courage to plumb the depths of our fear and enable ourselves to be free of its inhibitions and disabling effects.  This process of inner exploration will gradually unearth the depths of our internal resources and capacity to handle deeply-felt emotions such as fear and grief.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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Self-Compassion Can Transform You

Over the last couple of posts I discussed how self-compassion can free us from the bonds of self-judging and explored some of the challenges involved in self-compassion meditation, including breaking through our defences and denial.

In this post, I want to share two stories told by Tara Brach of how self-compassion can transform our lives.

From prison bully to freedom

Tara Brach has worked extensively in prisons teaching mindfulness to prisoners.  In the course on the Power of Awareness,  she tells the story of a woman in prison who was a tough bully and very mean but who came to one of her 6 weeks courses.  During the course she heard the words of the poem, Please Call Me by My True Names by Thich Nhat Hanh.

These were the words of the poem that broke through the defences of the woman prisoner:

I am the twelve-year-old girl,
refugee on a small boat,
who throws herself into the ocean
after being raped by a sea pirate.
And I am the pirate,
my heart not yet capable
of seeing and loving.

In the preamble to the poem, Thich Nhat Hanh explains that had he been born in the same place as the pirate and lived in the same demeaning conditions, he would have been the pirate.  He goes on to explain that this realisation releases our compassion towards ourselves and others.

The woman prisoner realised that she too was suffering through the circumstances of her life and this realisation enabled her to be kind and compassionate to herself, to stop viewing herself as “bad” and to refrain from acting out her hurt and suffering through meanness to other prisoners.

Tara Brach explained that often we block self-compassion by telling ourselves that others have had it worse, so we should not be acting out our own suffering and pain.

From self-loathing to self-compassion

Tara Brach tells the story of a woman who knew that her ex-husband abused her daughter.  She could not face the pain of this knowledge, so she turned to alcohol to hide her shame, anger and self-loathing.

Her transformation came when, in desperation, she sought the advice of a priest who showed her (by drawing as small circle on her hand), that she was living in a small destructive circle of anger and self-aversion.  She had cut herself off from truly living and experiencing the world around her because she could not face the pain within.  The priest placed his large hand over hers to symbolise that there was a larger field of kindness and forgiveness that she could access to free herself from the tyranny and blindness of self-loathing.

As she meditated thinking of the hand of mercy covering her narrow circle of life, she came to realise that kindness and self-compassion lay within – it is inborn and accessible if only we are open to it.

Through meditation we can grow in mindfulness and come to the realisation of our own pain and suffering that blocks our self-compassion.  If we persist with meditation practice, we can open our hearts to innate kindness towards ourselves and be more present to the beauty of the world around us.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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The Hidden Challenges in Self-Compassion Meditation

In the previous post, I explored what happens when a negative experience continues to recur because of our habituated behaviour, even after employing the R.A.I.N. meditation process.  I then focused on using self-compassion to break the bonds of negative self-evaluation that inevitably occurs.

However, self-compassion, being kind to ourselves, brings up its own challenges and resistances.

Challenges embedded in self-compassion meditation
  1. The evasive end goal

How do you know you have arrived?  When can you say you have reached the end point – completed the journey of self-discovery through self-compassion?   There is no single end point – only a deeper level of progression into our inner world and what lies below the surface.

2. The defences we have developed

We avoid pain at every opportunity and self-compassion meditation makes us vulnerable – we have to visit the centre of our internal hurt.  We ward off this vulnerability by convincing ourselves that we must be doing it wrong because this keen sense of vulnerability should not be happening.

3. Failure to recognise the pervasiveness of our negative self-evaluations

There are typically so many moments and situations where we view ourselves as not measuring up or “falling short”.  It is so easy to deny or dismiss these negative self-evaluations with a flippant and groundless self-belief that “I am not like that”.   Yet the sense of “unworthiness” can impact every facet of our life at work, at home and in the community.  We lack trust in others because we are concerned that someone might find out what we are really like.

4. “False refuges” 

When we think we do not meet the expectations of our peers, family or society generally, we may employ strategies that Tara Brach calls “false refuges” – ways of numbing the pain of our shame or of competing to deflect self-examination and self-realisation.

5. Unable to give ourselves self-compassion because it is too big a challenge

People may say that they can’t experience the real sense of vulnerability nor give themselves self-compassion.  Tara Brach suggests that, in these situations, they at least should think of someone else who would be able and willing to offer them loving kindness.

Self-compassion requires vulnerability

Tara Brach, in the  Power of Awareness Course,  suggests that the beginning of self-compassion is:

To be able to see clearly that place of vulnerability and pain – that place of self-aversion, turned on ourselves.  The alchemy of self-compassion is to touch the place of vulnerability – to really feel the “ouch”, the place inside us that is really hurting.  In that place is a natural tenderness.

So, self-compassion is both feeling the pain and hurt of self-realisation and offering ourselves kindness and acceptance.  It is not a passive stance, but an active one of entering the pain zone while fortified by our own deep kindness and self-care.  It involves breaking down our defences, being open to the extent of our self-denigration and avoiding the “false refuges” that are forever a temptation to avoid pain.

As we grow in mindfulness through meditation practices, we are better able to identify and remove our defences, to cope with the pain of realisation and to reach out to ourselves with loving kindness.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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Remember the R.A.I.N.

R.A.I.N. is a meditation process designed to help you when you have a situation where you experience strong negative feelings towards another person.  The process was recently introduced by Tara Brach as part of the Power of Awareness Course.

The acronym stands for Recognise, Accept, Investigate and Nurture.  Each of these steps can be undertaken during a meditation following an interaction with another person – partner, colleague, child, boss- that disturbs your equilibrium or, if you have the presence of mind at the time, during the disturbing interaction itself.  Let’s have a look at what these steps involve.

Recognise your emotions

After adopting an introductory grounding meditation practice, you need to reflect on the upsetting interaction and try to recognise your feelings at the time.  As we mentioned previously, identifying and naming your feelings, enables you to tame them.  Sometimes, this can be a complicated mix of feelings and other times involve feelings reflecting two different orientations –  feelings about the other person and feelings about yourself. For example, you might feel frustration and anger towards the other person (especially, if their behaviour that has an adverse effect on you is repeated often).  You might also be anxious that the resulting conflict, and your own inappropriate response at the time, puts your relationship in jeopardy.

Accept the interaction and the contributing factors

Life is not simple – nor is it free from stress and conflict – we are all unique and have different ideas, values, preferences, behaviours and idiosyncrasies.  Accepting the reality of the adverse interaction is an important part of moving on.  You can wallow in your hurt feelings and maintain your resentment, but this will be detrimental to yourself and the other person.  Your anger will pervade your thoughts and distort your perception of the other person and also manifest itself in your behaviour towards them and others.  The way ahead is to process your residual feelings, accept what has happened and move onto the investigation step.

Investigate your feelings that occurred during the interaction

This is not a conceptual exercise, where you stay just with your thoughts and objective analysis.  It entails being fully embodied – noting where in your body the pain and hurt associated with the feelings resides.  What do the feelings do to your body?  Are the negative thoughts and feelings expressed as tension in your forehead, tightness in your shoulders, an ache in your back or  other physical manifestation?  Focusing on the areas of pain and aching, enables you to release the physical unease and the associated thoughts and feelings.

Nurture yourself through the process

It is important to treat yourself with kindness, not scorn or derision.  The latter approach leads to low self-esteem and the belief that you are unable to do anything about the relationship because you “lost it” or were inept in the interaction.  Caring for yourself is critical, otherwise distress about the other person’s words and actions can lead to distress about what you said and did.   This only exacerbates an unsettling experience.

As you emerge from the R.A.I.N. meditation, you will have a strong sense of freedom and the basis for a new relationship with the other person.  As you grow in mindfulness, you will be better able to undertake these steps during the interaction itself, rather than afterwards.  So the R.A.I.N. meditation can also help you with future interactions with the same person.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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Further Reflections on an Action Learning Intervention

This post represents a further reflection on the action learning intervention undertaken by Dr. Rod Waddington in South Africa.  It follows on from my previous reflections on the values differences between narcissism and action learning.

In another earlier post, I highlighted the need to support mindfulness training with organisational interventions designed to address things like over-work, lack of agency, managerial style and toxicity.  This was the perspective of the union body in the UK and the Mindful UK Report.   Now I turn to ways that mindfulness could strengthen an action learning intervention that did address these identified issues.

In the current reflection, I want to highlight the role that mindfulness could play in enhancing the outcomes of the action learning intervention by focusing on self-awareness and resilience.

Mindfulness strengthening self-awareness

One of the outcomes that Rod’s intervention in an education setting in South Africa had in common with Dr. Diana Austin’s intervention in a health setting in New Zealand, is the personal disclosure by participants of what they were experiencing and feeling and what contributed to their pain and suffering.  In the case of the college, the disclosure related to the style of management and the toxicity of the workplace; in the health setting, midwives identified the lack of support that they received following a critical incident.

In both cases, participants had suffered in silence and not shared with others what was happening for them – they were engaged in a “conspiracy of silence”.  The collaborative environment provided by action learning enabled them to feel safe and to be open about what they really thought and felt.

If mindfulness training had preceded these interventions, participants could be more aware of themselves and more willing to share at a deeper level. Mindfulness brings with it self-awareness and increased insight into factors impacting thoughts, feelings and reactions.  Participants would also be better placed to support each other through the disclosure experience.

Mindfulness strengthening resilience

If participants in an action learning program had been exposed to mindfulness over a reasonable period and had undertaken regular practice, they would have brought a higher level of resilience to the action learning intervention.  This, in turn, would contribute to the ability to sustain the outcomes of the intervention as participants would be better able to manage setbacks and difficulties.

The potential contribution of mindfulness for an action learning intervention

As potential participants in an action learning intervention grow in mindfulness through meditation training, they bring to the intervention a greater capacity to contribute openness and honesty, make the most of the opportunities for increased agency and contribute to the sustainability of the intervention through their enhanced resilience.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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Engaging With and Accepting Death

Annie Robinson, in her article, How Mindfulness Can Ease the Fear of Death and Dying, asserts that there is a strong movement in the West to reengage with death, encourage open conversations about death, and to pursue choices in dying that respect the values and vision of the dying person.  This is also the theme of Lucy Kalanithi’s TED talk and Paul Kalanithi’s book,  When Breath Becomes Air, which he wrote while suffering from terminal cancer.

There are a number of characteristics of this movement and approach which involve dying mindfully:

Acceptance of death

Acceptance involves not only acknowledging the onset of death but all the feelings and thoughts that go with it.  This includes denial, sadness, suffering, anger, fear, grief and sense of loss associated with declining mental and physical capacity as well as the ultimate separation from loved ones.  It also includes accepting the loss of our old identity and an envisioned future and progressively forging a new identity and vision of dying.  Mindful acceptance does not remove the suffering but can reduce the pain and fear of death.

Being attuned to sensory experience

This involves paying attention to our senses – touch, taste, sight, hearing and smell- and experiencing the sensations such as a beautiful scene or sweet-smelling flower to a heightened degree.  It involves resting in these sensations while we can still experience them.  Some of these sensations will be intensified as we focus on them with our waning energy.  Annie suggests that being attuned to our sensory experience can develop joy and mindfulness.  Jon Kabat-Zinn, author of Coming to Our Senses, has demonstrated that focused attention on our senses can alleviate pain and help us to rewrite the narrative in our heads (including the narrative of fear and depression).

Finding balance through openness to love

Remaining open to love and caring of a partner, parents, children and relatives enables the dying person to find some level of balance as they alternate between pain and joy.  This requires vulnerability as their faculties decline and dependence increases; it also means that bitterness over loss on every dimension is not permitted to gain a stranglehold on emotions.  In his book, Paul Kalanithi was able to talk about marriage difficulties arising from his extreme workload as a neurosurgeon resident, working from 6am to late at night, 7 days a week.   His wife, Lucy, in the Epilogue to Paul’s book acknowledged that the cancer diagnosis enabled them to reinvigorate and deepen their love for each other and, in the face of  Paul’s dying, “to be vulnerable, kind, generous, grateful”.

Lucy wrote about the balance that emerged through their complete acceptance and trust in each other:

Although these last few years have been wrenching and difficult – sometimes almost impossible – they have also been the most beautiful and profound of my life, requiring the daily act of holding life and death, joy and pain in balance and exploring new depths of gratitude and love (p.219)

Lucy acknowledged that as you grow in mindfulness, you can find joy amidst the pain and grief, meaning when all seems lost and a profound gratitude that engenders fortitude and courage.

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Dying Mindfully

Lucy Kalanithi, in her Ted talk, What makes life worth living in the face of death, shared the story of her last 22 months with her husband who was suffering from terminal cancer.   Her husband, Paul, a young neurosurgeon, was able to continue his practice for a while after his cancer diagnosis owing to his oncologist’s management of his chemotherapy.

After Paul was unable to continue as a neurosurgeon, he turned to writing which he continued to do until the last months of his life.  Paul’s book is titled, When Breath Becomes Air.   The book is a reflection on the task of transitioning from doctor to patient.  It describes the challenge of facing his own death –  a challenge that both Paul and Lucy had assisted their patients to face.

Lucy explained in her talk that together they accepted that suffering and death were part of life – but this did not remove the pain and suffering involved.  When reflecting on life and its purpose she said:

Engaging in the full range of experience — living and dying, love and loss — is what we get to do.  

Lucy said that instead of fighting against fate, she and Paul learnt together how to deal with the here and now of suffering and loss – they worked together to help each other through.

Part of their approach to Paul’s dying was to talk with each other openly and honestly about their feelings and the difficult decisions that they faced progressively:

  • whether to have a child (with Paul’s uncertain life expectancy)
  • whether Lucy should remarry after Paul died
  • what level of medical intervention they would accept at different stages of Paul’s illness
  • when to turn off life support.

Lucy commented that talking through the options, helping each other make those decisions and accepting the pain and loss involved at each stage, gave her a new insight into the meaning of resilience – because it could not mean, in their circumstances, “bouncing back” to a prior state.  Paul had to redefine his identity throughout the illness as he lost physical and mental capacities and Lucy had to find a new meaning in her role as “caregiver”.  Together, though, they showed the resilience of facing dying mindfully, of being present to the current reality confronting them and not meeting it with denial.

Paul also used his final months to reflect on what he was experiencing in the hope that his written reflections could help other patients going through what he was experiencing and help clinicians to understand the dying patient’s journey from the inside.

In her final comment, Lucy stated that exercise and mindfulness meditation helped her a lot.  As we grow in midnfulness, we can help each other during the experience of dying and develop a new resilience in the face of an inevitable, changed reality.

By Ron Passfield – Copyright (Creative Commons license, Attribution–Non Commercial–No Derivatives)

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